Exam 3

• Concepts of Growth and Development

  • Growth
  • Physical changes
  • Development
  • Increase in complexity of skills
  • Behavioral aspects of growth
  • Psychological benchmarks
• Factors That Influence Growth and Development

  • Biological and hereditary
  • Illnesses (e.g., Cerebral palsy, anoxic brain injury)
  • Environmental (e.g., Nutrition, exposure to chemicals like lead)
  • Social (e.g., Violence/abuse, Resources/support systems)
• Theories of Development

  • Physical (Physical size and functioning)
  • Psychosocial (Erikson's Theory)
  • Cognitive (How we learn, Piaget’s Theory)
  • Moral (Ability to think at higher levels and develop a value system that differentiates right from wrong)
• Development of Infants

  1. Doubled birth weight by 6 months

  2. Tripled birth weight by 1 year

  3. Fontanels not yet fused

  4. Eruption of deciduous teeth

  5. Pincer grasps develops

  6. Object permanence
• Development of Toddlers

  1. Slowed growth and rapid development

  2. Gain 4-6 pounds per year, 3 inches per year

  3. 20 deciduous teeth

  4. Sphincter muscle control

  5. Stand alone and walk
• Development of Toddlers (Psychosocial)

  1. Autonomy vs. Self Doubt

  2. Need the opportunity to make decisions with limited choices

  3. Too many choices can be overwhelming

  4. Allow them to do tasks themselves (Dressing, Feeding)

  5. “Temper Tantrums” (Child’s frustration at not being in control)
• Development of Toddlers (Play)

  1. Parallel play (toddler plays near another without sharing)

  2. Sharing requires parental intervention and positive reinforcement

  3. Benefit from large, colorful, safe toys

  4. Risk of choking and aspiration
• Development of Preschoolers

  1. Gain 4-5 pounds per year, 2 ½-3 inches per year

  2. Better balance and body control

  3. Gross and fine motor skills continue to develop rapidly

  4. Throw and catch a ball

  5. Climb

  6. Magical thinking
• Development of Preschoolers (Psychosocial)

  1. Initiative vs. guilt

  2. Need to be allowed to pretend, role play, explore identity, develop independence
• Development of School-Age Children

  1. Growth is slow and steady

  2. Lose baby teeth

  3. Can ride a bicycle

  4. Can cut, paste, print, draw with detail

  5. Developing coordination
• Development of School-Age Children (Psychosocial)

  1. Industry vs. inferiority

  2. Industrious in various ways, may have unrealistic expectations
• Development of Adolescents

  1. Growth spurt

  2. Puberty

  3. Wisdom teeth erupt
• Development of Adolescents (Psychosocial)

  1. Identity vs. role confusion

  2. Establishing own identity apart from parents and family
• Types of Play

  • Infants: solitary
  • Toddlers: parallel
  • Pre-schoolers: associative
  • School-aged children: cooperative
  • Adolescents: cooperative; abstract problem solving
• Health Concerns for Infants and Toddlers

  • Safety
  • Prevent falls
  • Prevent choking
  • Prevent drowning
  • Health Teaching
  • Proper nutrition
  • Breast milk versus formula
  • Provide variety of foods
  • Discipline
  • Back to sleep
• Screening and Health Promotion for the Infant

  1. Well-child check-ups and immunizations

  2. Measurements, including HC, weight, and length checks

  3. Developmental milestone checks

  4. Maintain records of well-child check-ups

  5. Immunizations for active immunity against diseases
• Health Concerns for Preschoolers and School-Age Children

  • Safety
  • Stranger danger
  • Playground safety
  • Water safety
  • Health Teaching
  • Hygiene
  • Bedtime routine
  • Health screenings
• Screening and Health Promotion for the School-Aged Child

  1. Systematic health screenings

  2. Immunizations

  3. Hearing screening

  4. Visual screening

  5. Scoliosis screening

  6. Child abuse screening

  7. Lice screening

  8. Dental screening

  9. Blood pressure screening

  10. BMI screening

  11. Well-child visits
• Health Concerns for Adolescents

  • Safety
  • Experimentation
  • Risk-taking behaviors
  • Internet social networking
  • Firearms
  • Health Teaching
  • STDs, birth control, and pregnancy
  • Suicide
• Health Concerns for Adolescents (Nursing Implications)

  1. Allow some control over schedules

  2. Treat with respect and dignity

  3. Peer groups are important
• Human growth

  Physical changes from birth to adulthood
• Human development

  Psychological, emotional, and social changes throughout a person's life
• Psychological development according to Erikson

  Individuals go through eight stages of psychosocial development, each characterized by a specific conflict that must be resolved
• Stages of child development

  • Infancy
  • Early childhood
  • Middle childhood
  • Adolescence
• Nurses should consider the unique physical, emotional, and cognitive needs of individuals at different stages of development to provide appropriate care and support
• Growth involves physical changes
• Physical changes during growth

  • Increase in height
  • Development of secondary sexual characteristics
  • Changes in body proportions
  • Growth of bones and muscles
• Development includes increased complexity of skills, behavioral aspects, and psychological benchmarks
• Factors That Influence Growth and Development

  • Biological and hereditary factors like illnesses (e.g., Cerebral palsy, anoxic brain injury)
  • Environmental factors such as nutrition and exposure to chemicals like lead
  • Social factors like violence/abuse and availability of resources/support systems
• Theories of Development

  • Physical development involves physical size and functioning
  • Psychosocial development is explained by Erikson's Theory
  • Cognitive development relates to learning and is explained by Piaget’s Theory
  • Moral development involves thinking at higher levels and developing a value system
• Development of Infants (28 days-1 year)

  1. Physical/Cognitive development milestones

  2. Doubled birth weight by 6 months

  3. Tripled birth weight by 1 year

  4. Fontanels not yet fused

  5. Eruption of deciduous teeth

  6. Pincer grasps develop

  7. Object permanence (peek-a-boo)
• Development of Toddlers (1-3 years old)


  1. Physical development milestones

  2. Gain 4-6 pounds per year, 3 inches per year

  3. Slowed growth and rapid development

  4. Sphincter muscle control develops

  5. 20 deciduous teeth

  6. Stand alone and walk

  7. Centers around autonomy vs. self-doubt
• Development of Preschoolers (3-6 years old)

  1. Physical/Cognitive development milestones

  2. Gain 4-5 pounds per year, 2 ½-3 inches per year

  3. Develop better balance and body control

  4. Magical thinking

  5. Centers around initiative vs. guilt
• Development of School-Age Children (6-10 years old)

  1. Physical development milestones

  2. Slow and steady growth

  3. Growing pains

  4. Lose baby teeth

  5. Developing coordination and skills like riding a bicycle

  6. Developing coordination

  7. Centers around industry vs. inferiority
• Development of Adolescents (11-18 years old)

  1. Physical milestones include growth spurt, puberty, Wisdom teeth erupt

  2. Psychosocial development focuses on identity vs. role confusion
• Types of Play

  • Infants: solitary
  • Toddlers: parallel
  • Pre-schoolers: associative
  • School-aged children: cooperative
  • Adolescents: cooperative; abstract problem solving
• Development Check: A nurse helps an infant develop trust through providing consistent care and attention, responding promptly to the infant's needs, creating a safe and nurturing environment, building a strong bond through positive interactions, encouraging healthy attachment and emotional connection
• Nurse's Role in Toddler Autonomy Development: A nurse can support a toddler's autonomy by encouraging decision-making, offering choices, fostering independence in self-care tasks, and providing a safe environment for exploration and learning
• A nurse can help a preschooler develop initiative by providing a safe and nurturing environment, encouraging exploration and independence, offering praise and positive reinforcement, supporting decision-making and problem-solving skills, engaging in imaginative play and creative activities
• A nurse can help a school-age child develop industry by encouraging participation in activities, providing support and guidance, promoting self-confidence and independence, offering health education and resources